Vital Parameters in Children
Vital sign is an objective dimension of crucial physiological functions of human beings. This dimension is first and essential step in clinical examination. Classification of patients in any emergency or disaster is grounded on bases of their vital signs [1]. It is very important that healthcare providers must understand the physiologic and pathologic processes affecting these assessments and their genuine analysis.
Temperature
Body temperature reflects the balance between the heat production and heat lost from the body. It is measured in degrees. Axillary temperature is taken in infants and younger children while in children older than 5 year’s temperature should be taken via Oral cavity/groin or rectum [2]. The temperature in the axilla or the groin is about 0.5° C lower and the rectal temperature about 0.5° C higher than the oral temperature. The temperature measurement taken by the tympanic method is in the same range as the oral method. The normal temperature in children is between 36.5° C and 37.5° C. Temperature above 41° C is hyperpyrexia.
- Vital Parameters in Children
- Commentary
- Volume 6 Issue 2
- Received Date: March 08, 2022
- Published Date: March 14, 2022
- DOI: 10.23880/nhij-16000259
- Age groups
- Normal heart rate (per minute)
- Newborn
- 140 bpm
- 1 year
- 110 bpm
- 3 years
- 100 bpm
- 8 years
- 90 bpm
- 10 years
- 80 bpm
Table 1: The normal heart rates in children of different age
Pulse Rate
Heart ventricles contract to force the blood into the aorta, arterial walls in the vascular system. The pressure wave causing the expansion in vessels is called the pulse. Counting each pulsation of the arterial wall gives us the pulse rate [3, 4, 5]. The superficial temporal, carotid, brachial, radial, femoral, popliteal, posterior tibial and dorsalis pedis arteries are easily accessible. In infants and very young children, it may not be possible to palpate the peripheral vessels and in such situations, the heart rate must be counted by auscultation (Table 1).
- Respiratory Rate
- Respiration is defined as the exchange of oxygen and carbon dioxide in the lungs and tissues which is initiated by the act of breathing [6,7]. Respiration rate is important for diagnosing certain respiratory and non- respiratory diseases
- (Table 2).
- Age groups
- Normal respiratory rate (per minute)
- Newborn
- 40 bpm
- 1 year
- 30 bpm
- 5 years
- 20 bpm
- 10 years
- 18 bpm
Table 2: Normal respiratory rate in children of different age
Blood Pressure
Blood pressure is one of the important assessments in pediatric examination. In children Doppler technique of measuring blood pressure can be used as it is more accurate. In any child with a suspected cardiac illness, the pressure must be recorded in all four limbs and for pediatric examination, both the upper limb and lower limb pressures must be recorded to detect coarctation of aorta [8]. The pressure recorded in the lower limbs is about 10 mm Hg higher than the upper limbs.
| Systolic Blood Pressure | Diastolic Blood Pressure | |
|---|---|---|
| Birth (12 h) | 60-85 mmHg | 45-55 mmHg |
| Neonate (96 h) | 67-84 mmHg | 35-53 mmHg |
| Infant(1-12 mo) | 80-100 mmHg | 55-65 mmHg |
| Toddler (1-2 y) | 90-105 mmHg | 55-70 mmHg |
| Preschooler (3-5 y) | 95-107 mmHg | 60-71 mmHg |
| School-age (6-9 y) | 95-110 mmHg | 60-73 mmHg |
| Preadolescent (10-11 y) | 100-119 mmHg | 65-76 mmHg |
| Adolescent (12-15 y) | 110-124 mmHg | 70-79 mmHg |
Table 3: Normal Blood Pressure by Age.
References
-
Mersch J (2022) Pediatric Vital Signs by Age: Charts and Ranges. eMedicineHealth.
-
Vital Signs in Children, CS Mott Children’s Hospital | Michigan Medicine.
-
Wing R, Dor MR, McQuilkin PA (2013) Fever in the pediatric patient. Emergency Medicine Clinics of North America 31(4): 1073-1096.
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van de Maat J, Jonkman H, van de Voort E, Mintegi S, Gervaix A, et al. (2020) Measuring vital signs in children with fever at the emergency department: an observational study on adherence to the NICE recommendations in Europe. Eur J Pediatr 179(7): 1097-1106.
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Batra P, Saha A, Faridi MM (2012) Thermometry in children. J Emerg Trauma Shock 5(3): 246-249.
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Callanan D (2003) Detecting fever in young infants: reliability of perceived, pacifier, and temporal artery temperatures in infants younger than 3 months of age. Pediatr Emerg Care 19(4): 240-243.
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Craig JV, Lancaster GA, Taylor S, Williamson PR, Smyth RL (2002) Infrared ear thermometry compared with rectal thermometry in children: a systemic review. Lancet 360(9333): 603-609.
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Craig JV, Lancaster GA, Williamson PR, Smyth R L (2000) Temperature measured at the axilla compared with rectum in children and young people: systematic review. BMJ 320(7243): 1174-1178.
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